pediatric-development

How Grief Looks Different at Each Age

Children grieve by developmental stage, not like adults. Toddlers grieve in brief intense bursts, preschoolers may see death as reversible, and by 5 to 7 most kids grasp that death is permanent and universal.

Talk to a clinician

Dr. Maya Ellison — Child Psychologist

Childhood grief and bereavement: distinguishing typical from prolonged grief with validated tools, grief-focused CBT, and school coordination. Gale can match you with a licensed clinician for a visit.

Find care →

Why a child's grief doesn't look like yours

Grief in children is shaped by their understanding of death, which develops with age. Preschool children typically view death as temporary and reversible, almost like a long trip, while children roughly five to nine begin to think about death more like adults do 1Ref 1American Academy of Child and Adolescent Psychiatry (AACAP) (2018).Children and Grief (Facts for Families No. 8).Preschoolers view death as temporary and reversible; children five to nine begin to think about death more like adults; lists signs a grieving child may need professional help.. Researchers describe a mature death concept as having three parts that most healthy children reach between about five and seven years old: that death is irreversible, that the body stops working, and that it happens to everyone 2Ref 2Speece MW, Brent SB (1984).Children's Understanding of Death: A Review of Three Components of a Death Concept.Between about five and seven most healthy children achieve a mature death concept: irreversibility, nonfunctionality, and universality.. Before those ideas land, a child's reactions can seem puzzling, but they are developmentally normal.

How grief shows up at different ages

Toddlers and preschoolers (ages 2 to 4) often have brief but intense grief responses and may believe the person can come back; they grieve in short bursts and then return to play 4Ref 4The Dougy Center: The National Grief Center for Children & Families (2022).Developmental Responses to Grief (Ages 2-18).Children grieve by developmental stage: ages 2-4 see death as reversible with brief intense responses; ages 4-7 begin to grasp finality while fearing bodily harm.. Around ages 4 to 7, children begin to grasp finality while still worrying about bodily harm or wondering if they caused the death 4Ref 4The Dougy Center: The National Grief Center for Children & Families (2022).Developmental Responses to Grief (Ages 2-18).Children grieve by developmental stage: ages 2-4 see death as reversible with brief intense responses; ages 4-7 begin to grasp finality while fearing bodily harm.. After a loss, young children may regress to behaviors like thumb-sucking or bedwetting, and these reactions are common in the early weeks 5Ref 5Substance Abuse and Mental Health Services Administration (SAMHSA) (2023).Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers.Preschoolers may regress to thumb-sucking or bedwetting; seek more help if reactions persist beyond two to four weeks.. Grief in kids is often expressed through play, drawings, questions, and behavior rather than tears or talk, and it tends to ebb and flow rather than follow neat stages.

Grief that comes back over time

Children often revisit a loss as they grow and can understand it in new ways, so a death that happened in preschool may resurface with fresh questions at age nine or in adolescence 3Ref 3Schonfeld DJ, Demaria T; AAP Committee on Psychosocial Aspects of Child and Family Health (2016).Supporting the Grieving Child and Family.Developmentally appropriate guidance on how children understand death at different ages and how to support the grieving child and family.. This is normal, not a setback. Honest, age-appropriate language and keeping familiar routines help a child feel secure while they make sense of the loss again and again 4Ref 4The Dougy Center: The National Grief Center for Children & Families (2022).Developmental Responses to Grief (Ages 2-18).Children grieve by developmental stage: ages 2-4 see death as reversible with brief intense responses; ages 4-7 begin to grasp finality while fearing bodily harm..

How parents can help

Use plain, concrete words like 'died' rather than 'went to sleep' or 'we lost them,' which can confuse young children. Answer questions honestly and simply, repeat answers as often as needed, and keep daily routines steady so the world feels predictable 4Ref 4The Dougy Center: The National Grief Center for Children & Families (2022).Developmental Responses to Grief (Ages 2-18).Children grieve by developmental stage: ages 2-4 see death as reversible with brief intense responses; ages 4-7 begin to grasp finality while fearing bodily harm.. Let your child see your own grief in measured ways so they learn that feelings are allowed. Most children move through grief with the support of caring adults and do not need formal treatment.

When a clinician helps

Most grieving children heal at home, but a clinician adds real value when grief becomes stuck or starts to impair daily life. Around one in ten bereaved youth develop prolonged grief disorder, a distinct and treatable pattern that goes beyond ordinary sadness 6Ref 6van Dijk I, Boelen PA, de Keijser J, Lenferink LIM (2023).Assessing DSM-5-TR and ICD-11 Prolonged Grief Disorder in Children and Adolescents: Development of the Traumatic Grief Inventory – Kids – Clinician-Administered.Around 10% of bereaved youth develop prolonged grief disorder; a validated clinician-administered instrument maps DSM-5-TR and ICD-11 PGD criteria for youth.. A child mental health clinician can use validated tools to tell typical grief from prolonged or traumatic grief 6Ref 6van Dijk I, Boelen PA, de Keijser J, Lenferink LIM (2023).Assessing DSM-5-TR and ICD-11 Prolonged Grief Disorder in Children and Adolescents: Development of the Traumatic Grief Inventory – Kids – Clinician-Administered.Around 10% of bereaved youth develop prolonged grief disorder; a validated clinician-administered instrument maps DSM-5-TR and ICD-11 PGD criteria for youth., rule out medical or sleep problems contributing to changes, and offer evidence-based treatment such as grief-focused cognitive behavioral therapy, which significantly reduces prolonged grief, depression, and PTSD symptoms in children 7Ref 7Boelen PA, Lenferink LIM, Spuij M (2021).CBT for Prolonged Grief in Children and Adolescents: A Randomized Clinical Trial.Grief-focused CBT significantly reduced prolonged grief, depression, and PTSD symptoms in bereaved children versus supportive counseling.. Clinicians can also coordinate with a child's school so supports follow them into the classroom 8Ref 8Schonfeld DJ, Demaria T, Nasir A, Kumar S; AAP Committee on Psychosocial Aspects of Child and Family Health and Council on Children and Disasters (2024).Supporting the Grieving Child and Family (Clinical Report).Pediatricians should use a family-centered, trauma-informed approach and coordinate supports for grieving children and families.. Consider reaching out if intense reactions persist beyond two to four weeks, if your child talks about wanting to die, or if grief blocks eating, sleeping, school, or play 5Ref 5Substance Abuse and Mental Health Services Administration (SAMHSA) (2023).Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers.Preschoolers may regress to thumb-sucking or bedwetting; seek more help if reactions persist beyond two to four weeks..

Common questions

Is it normal for my child to play right after hearing sad news?

Yes. Young children often grieve in short, intense bursts and then return to play. This is a healthy way their minds take breaks from big feelings, not a sign they don't care.

Should I use the word 'died' with a young child?

Yes. Plain, concrete words like 'died' are clearer than 'passed away' or 'went to sleep,' which can confuse young children and even make them afraid of sleep or trips.

Will my child grieve the same loss again as they get older?

Often, yes. Children revisit losses as they grow and understand them in new ways, so questions can resurface years later. This is normal and a chance to talk again.

Talk to a clinician

Dr. Maya Ellison — Child Psychologist

Find care →

When to reach out for support

—Intense grief reactions that persist or worsen beyond two to four weeks
—Withdrawal from friends, school, or activities they once enjoyed
—Ongoing trouble eating or sleeping
—Strong belief they caused the death or persistent guilt
—Any talk of wanting to die or self-harm

This article is educational and does not diagnose your child or replace care from a qualified clinician. If you are worried, reach out to your pediatrician or a child mental health professional.

References

1.American Academy of Child and Adolescent Psychiatry (AACAP) (2018). Children and Grief (Facts for Families No. 8). AACAP Facts for Families. link ✓Preschoolers view death as temporary and reversible; children five to nine begin to think about death more like adults; lists signs a grieving child may need professional help.
2.Speece MW, Brent SB (1984). Children's Understanding of Death: A Review of Three Components of a Death Concept. Child Development, 55(5), 1671-1686. doi:10.2307/1129915 ✓Between about five and seven most healthy children achieve a mature death concept: irreversibility, nonfunctionality, and universality.
3.Schonfeld DJ, Demaria T; AAP Committee on Psychosocial Aspects of Child and Family Health (2016). Supporting the Grieving Child and Family. Pediatrics. doi:10.1542/peds.2016-2147 ✓Developmentally appropriate guidance on how children understand death at different ages and how to support the grieving child and family.
4.The Dougy Center: The National Grief Center for Children & Families (2022). Developmental Responses to Grief (Ages 2-18). The Dougy Center. link ✓Children grieve by developmental stage: ages 2-4 see death as reversible with brief intense responses; ages 4-7 begin to grasp finality while fearing bodily harm.
5.Substance Abuse and Mental Health Services Administration (SAMHSA) (2023). Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers. SAMHSA Publications (PEP23-01-01-012). link ✓Preschoolers may regress to thumb-sucking or bedwetting; seek more help if reactions persist beyond two to four weeks.
6.van Dijk I, Boelen PA, de Keijser J, Lenferink LIM (2023). Assessing DSM-5-TR and ICD-11 Prolonged Grief Disorder in Children and Adolescents: Development of the Traumatic Grief Inventory – Kids – Clinician-Administered. European Journal of Psychotraumatology, 14(2), 2197697. doi:10.1080/20008066.2023.2197697 ✓Around 10% of bereaved youth develop prolonged grief disorder; a validated clinician-administered instrument maps DSM-5-TR and ICD-11 PGD criteria for youth.
7.Boelen PA, Lenferink LIM, Spuij M (2021). CBT for Prolonged Grief in Children and Adolescents: A Randomized Clinical Trial. American Journal of Psychiatry, 178(4), 294-304. doi:10.1176/appi.ajp.2020.20050548 ✓Grief-focused CBT significantly reduced prolonged grief, depression, and PTSD symptoms in bereaved children versus supportive counseling.
8.Schonfeld DJ, Demaria T, Nasir A, Kumar S; AAP Committee on Psychosocial Aspects of Child and Family Health and Council on Children and Disasters (2024). Supporting the Grieving Child and Family (Clinical Report). Pediatrics. doi:10.1542/peds.2024-067212 ✓Pediatricians should use a family-centered, trauma-informed approach and coordinate supports for grieving children and families.

8 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.